I code for urology, and have a radical nephrectomy surgery case where two of our MD’s performed the nephrectomy together, one was primary, and the other the assistant surgeon. This is what we often see, and will add modifier 80 to the assistant surgeon, however, the patient had some aortic bleeding and a vascular surgeon was also involved in the case, so from a different specialty. I do not know the rules or guidelines on coding for co-surgeons, when there was also an assistant surgeon from our specialty involved in the case.

Normally we would code the CPT code for the primary surgeon, and then code the CPT again for the assistant surgeon with modifier 80.
since there was also a co-surgeon involved from a different specialty, would we add modifier 62 to the primary surgeon’s CPT to support the co-surgeon or is this not allowable when an assistant is also involved; does that "overrule" the assistant surgeon in this case?